WITH SOLUTIONS GRADED A+
◉How do you palpate the spleen? Answer: Place hands under the
LEFT coastal margins, press down. Have patient take deep breath,
exhale, press in further.
Normal to not be able to feel the spleen
◉A 38 y/o pregnant woman presents to you office complaining of
right upper quadrant pain and indigestion, especially after eating
fatty foods. On physical exam - you as her to inspire as you palpate
the right upper quadrant. If there is pain, what is this called? What
does it indicate? Answer: Positive Murphy's Sign
Cholecystitis
◉How does a distended bladder sound on percussion? Answer: Dull
◉What four techniques do you use to assess for appendicitis?
Answer: 1. Rebound tenderness at McBurney's point
,2. Rovsing's sign - referred peritoneal pain to the right side when
you press on the left side
3. Psoas sign - extend thigh and have pt flex and the hip
4. Obturator sign - flex leg at hip and knee and rotate medially and
laterally
◉What is Blumberg's sign? Answer: Rebound tenderness =>
peritonitis
◉What is hypersensitivity test? Answer: Pain or an exaggerated
sensation felt in the right lower quadrant when the skin is stroked
◉What two muscle tests are used to assess for appendicitis?
Answer: 1. Iliopsoas - passively extend the thigh
2. Obturator - flex leg at hip and knee and rotate the leg laterally and
medially
◉63 y/o male presents to your office for a well check. You are
reviewing his labs are see that his hemoglobin and hematocrit are
, low. What do you want to make sure to test? Answer: Colonoscopy
for colon cancer
◉Compare ulcerative colitis and Crohn's disease Answer: UC =
limited to COLON, bloody diarrhea, uniform inflammation, surgery is
curative
Crohns = anywhere in the GI system, nonbloody diarrhea, skip
lesions with cobblestoning
◉22 y/o female presents to your office with abdominal pain for the
past 3 months accompanied with nonbloody diarrhea. You decide to
send her for a colonoscopy. What are you testing for? Answer:
Inflammatory bowel disease - Crohns
◉Your are rounding in the hospital you see a patient complaining of
abdominal cramps, nonbloody diarrhea, and fever that started today.
On physical exam there is tenderness to abdominal palpation.
During you history you find out she has been in the hospital for an
abscess and has been taking clindamycin. What is high on your
differential diagnosis? Answer: Acute infectious diarrhea due to C.
Dif
◉A patient comes in to your office for a well check. He says he's
going on a trip to Mexico next week. You counsel him about staying